How do Lebanese patients perceive the ideal doctor based on the CanMEDS competency framework?

Mabel Aoun,Ghassan Sleilaty,Simon Abou Jaoude,Ronald Moussa,Dania Chelala

doi:10.1186/s12909-019-1837-y

Abstract

BackgroundDuring their training, Lebanese medical students develop a high medical expertise but are not focusing on other competencies such as communication, collaboration, erudition, professionalism, leadership and health promotion. There is also insufficient data about patients’ preference for these skills. This study describes the different weights patients attribute to these physician’s competencies.MethodsThis is a cross-sectional study based on a questionnaire distributed to 133 Lebanese patients. It included 15 questions assessing how patients prioritize the physician’s competencies, with open-ended questions asking them to define “the good doctor”. Krippendorff’s alpha coefficient was used to analyze the reliability of the competencies’ classification.ResultsOne hundred twenty five patients completed the questionnaire in this cross-sectional study. Their mean age was 48 ± 16.76 years. When classifying competencies, 73.6% opted for medical expertise as first choice and 48% put communication as second. Based on the Krippendorff’s coefficient, we identified a moderate agreement for the seven choices (alpha = 0.44). In open-ended questions, patients defined the good doctor in 325 answers: 64.3% mentioned medical expertise, 34.1% high ethics and 26.2% communication.ConclusionsThis patient-centered study concurs well with the worldwide practice that puts medical expertise at the center of medical education. However Lebanese patients don’t perceive equally other competencies and favor professionalism and communication that should be integrated in priority in students’ curricula.

Highlights

During their training, Lebanese medical students develop a high medical expertise but are not focusing on other competencies such as communication, collaboration, erudition, professionalism, leadership and health promotion
Socio-demographic characteristics of patients One hundred forty forms were distributed and 125 patients completed the questionnaire. 68.8% lived in the Mount-Lebanon area, the governorate that includes the highest number of inhabitants
74.4% had a physician of male gender, 68.8% were indifferent regarding the gender of their physician and the majority of them (70.4%) had a preference for a 40- to 60-year-old doctor. 61.6% consulted their physician more than once a year

Summary

Introduction

Lebanese medical students develop a high medical expertise but are not focusing on other competencies such as communication, collaboration, erudition, professionalism, leadership and health promotion. Medical education has largely evolved in the last decades and is focusing more on a training that takes outcomes into consideration These attained outcomes are competencies or abilities that a successful physician should possess in order to enhance patient care. The core of these competencies is the clinical one known as medical expertise that requires a vast amount of knowledge and clinical skills brought to medical students during their long years of training. Medical expertise alone is insufficient and needs to be backed up with nonclinical competencies that will lead a doctor’s performance to an excellence stage. In the United States, since 1999, another comprehensive competency framework is used in the training and

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